Relação entre orientação em saúde e complicações no pós-operatório de cirurgias torácicas e abdominais altas / Correlation between the healthcare guidance and thoracic and upper abdominal post-operative care / Relación entre orientación en salud y complicaciones en el postoperatorio de cirugías torácicas y abdominales alta

Objetivo: avaliar a influência das orientações em saúde nas complicações no pós-operatório de cirurgias torácicas e abdominais altas. Método: estudo quantitativo transversal realizado com 266 indivíduos. Os dados foram coletados por um questionário sociodemográfico, clínico e assistencial. Foram incluídos sujeitos de ambos os sexos, com faixa etária de 18 a 80 anos, que estivessem na enfermaria em pós-operatório de cirurgias torácicas e ou abdominais altas. Resultados: 82 (30%) dos indivíduos receberam orientações no período de pós-operatório e 184 (70%) não receberam nenhum tipo de orientação. Quatro dos sujeitos que receberam orientações desenvolveram algum tipo de complicação e 16 dos que não receberam tiveram complicações; não apresentando resultados estatisticamente significativos quanto aos pesquisados que tiveram orientação e os que não tiveram orientações (p=0,4). Conclusão: em relação ao número de complicações, ao comparar os indivíduos que receberam orientações com os que não receberam não houve resultado estatisticamente significativo

Objective: to evaluate correlation between health guidelines and complications in the postoperative period after thoracic and upper abdominal surgeries. Method: a cross-sectional quantitative study with 266 individuals. Data were collected by a sociodemographic, clinical and care questionnaire. We included subjects of both sexes, with ages ranging from 18 to 80 years, who were in the postoperative ward after thoracic and/ or upper abdominal surgeries. Results: 82 (30%) of the subjects received guidance in the postoperative period and 184 (70%) received no guidance. Four of the subjects who received guidelines developed some type of complication while 16 of those who did not receive guidance developed complications; therefore, the results were not statistically significant (p=0,4). Conclusion: in relation to the number of complications, when comparing individuals who received guidelines with those who did not receive, there was no statistically significant result

Objetivo: evaluar la influencia de las orientaciones en salud en las complicaciones en el postoperatorio de cirugías torácicas y abdominales altas. Metodo: estudio cuantitativo transversal realizado con 266 individuos. Los datos fueron recolectados por un cuestionario sociodemográfico, clínico y asistencial. Se incluyeron sujetos de ambos sexos, con rango de edad de 18 a 80 años, que estuvieran en la enfermería en postoperatorio de cirugías torácicas y / o abdominales alta. Resultados: 82 (30%) de los individuos recibieron orientaciones en el período de postoperatorio y 184 (70%) no recibieron ningún tipo de orientación. Cuatro de los sujetos que recibieron orientaciones, desarrollaron algún tipo de complicación y 16 de los que no recibieron tuvieron complicaciones; no presentando resultados estadísticamente significativos en cuanto a los encuestados que tuvieron orientación y los que no tuvieron orientaciones (p=0,4). Conclusión: en relación al número de complicaciones, al comparar a los individuos que recibieron orientaciones con los que no recibieron no hubo resultado estadísticamente significativo

The impact of recreational care activity in the immediate postoperative period / O impacto do cuidado lúdico no pós-operatório imediato / El impacto de la atención de recreo en el postoperatorio inmediato

Objective: The study's goal has been to understand the impact of playful educational actions performed by nurses in the immediate postoperative period, aiming to restore health promotion and maintenance strategies. Methods: It is an action-based research that was carried out in a municipal hospital in the Central region of Rio Grande do Sul State. The participants were hospitalized patients scheduled to undergo cholecystectomy procedure. This research was performed in three stages, as follows: the first one used a semi-structured questionnaire; the second, was the socialization of the recreational strategy developed by the researcher; and the third, sought to evaluate the effectiveness of the recreational activity. Data analysis was done by the content analysis under the thematic modality. Results: "Playfulness allied to therapeutic communication determining the confrontation of the perioperative process" and "Playfulness in the nursing consultation as a strategy toward the health education and self-care stimuli". Conclusion: The playful educational activities toward clients hospitalized for surgical procedure impact as a care methodology with innovative, active, and dialogic characteristics, then providing moments of demystification and understanding of the context that will be experienced in a creative and light way

Objetivo: Compreender o impacto de ações educativas lúdicas realizadas pelo enfermeiro no pós-operatório imediato, visando reconstruir estratégias de promoção e manutenção da saúde. Métodos: Trata-se de uma pesquisa-ação, realizada em um hospital municipal na região central, Rio Grande do Sul. Os participantes foram pacientes internados para realização de colecistectomia. Feita em três momentos, primeiro utilizou um questionário semiestruturado; segundo, a socialização da estratégia lúdica desenvolvida pelo pesquisador; terceiro, buscou avaliar a efetividade da ação educativa lúdica. Submetidos à análise de conteúdo, na modalidade temática. Resultados: "Ludicidade aliada à comunicação terapêutica determinando o enfrentamento do processo perioperatório" e "Ludicidade na consulta de Enfermagem como estratégia de educar para a saúde e estimular o autocuidado". Conclusão: As ações educativas lúdicas a clientes internados para a realização de procedimento cirúrgico impactam como uma metodologia de cuidado inovadora, ativa e dialógica, proporcionando momentos de desmistificação e compreensão do contexto que será vivenciado, de forma criativa e leve. Descritores: Educação em Saúde, Promoção da Saúde, Enfermagem, Ludicidade

Objetivo: Comprender el impacto de las actividades educativas recreativas llevadas a cabo por personal de enfermería en el postoperatorio inmediato, con el objetivo de reconstruir las estrategias de promoción y mantenimiento de la salud. Métodos: Se trata de una investigación en la acción llevada a cabo en un hospital municipal en la región central, RS. Los participantes fueron pacientes hospitalizados para la colecistectomía. Que tuvo lugar en tres etapas, que se utiliza por primera vez un cuestionario semi-estructurado, de acuerdo con la socialización de la estrategia de juego desarrollado por el investigador, en tercer lugar, tuvo como objetivo evaluar la eficacia de las actividades lúdicas educativas. Sometido a análisis de contenido, modalidad temática. Resultados: "Lo lúdico combinan con la comunicación terapéutica determinar la cara del proceso perioperatorio" y "Lo lúdico en consulta de Enfermería como una estrategia para educar a la salud y estimular el autocuidado." Conclusión: Las actividades lúdicas educativas a los clientes hospitalizados para llevar a cabo la cirugía de impacto como una metodología innovadora de atención, activa, y de diálogo, proporcionando momentos de desmitificación y la comprensión del contexto que se experimentará, forma creativa y la luz

Cuidado del niño en posoperatorio de cirugía cardiovascular: elaboración de una Guía de Práctica Clínica Basada en la Evidencia / Nursing care for the child in cardiovascular postoperatory: development of an Evidence-Based Clinical Practice Guideline", "_e": "n

Introducción: los pacientes pediátricos en posoperatorio de cirugía cardiovascular son críticos y hemodinámicamente inestables, a su ingreso a la Unidad de Cuidados Intensivos necesitan profesionales de Enfermería que brinden un cuidado acertado y oportuno. Objetivo: en este documento se presenta el proceso de elaboración de una guía de práctica clínica basada en la evidencia científica, que provee información confiable sobre las intervenciones de enfermería fundamentales para el cuidado de estos pacientes en etapa posoperatoria inmediata. Material y métodos: a partir de la metodología de la Enfermería Basada en Evidencia, se identificaron 24 temas de interés y se formularon 45 preguntas clínicas. Se realizó una búsqueda de literatura en 22 bases de datos con palabras claves en inglés y español. Resultados: se encontraron 150 documentos relacionados con el tema, se aplicó lectura crítica a 49 estudios relacionados con el cuidado directo y se logró responder a 24 preguntas clínicas con 58 recomendaciones. Gran parte de la evidencia corresponde al nivel 2+ según la clasificación de la Scottish Intercollegiate Guidelines Network, la mayoría de las recomendaciones son Grado C. Cabe resaltar que se encontraron 9 revisiones sistemáticas que permitieron formular recomendaciones Grado A y B, así como 3 estudios cualitativos publicados por enfermeras colombianas, brasileras y estadounidenses. Conclusiones: la mayoría de reportes de tipo clínico y fisiopatológico son producto de investigaciones médicas, son menos los reportes hechos por enfermeras. La evidencia actual disponible para enfermería no se limita únicamente a temas netamente clínicos; existen nuevas estrategias para el manejo no farmacológico del dolor, para promover el confort y para prevenir el delirio del niño, además se encuentra un soporte teórico y científico para la atención de las necesidades de los padres.

Introduction: pediatric patients in postoperative of cardiovascular surgery are critical and hemodynamically unstable, and during admission to the intensive care unit, they need nurses who provide correct and suitable care. Objective: this study presents the development process of a clinical practice guideline based on scientific evidence, to provide reliable information on basic nursing interventions for the care of these patients on immediate postoperatory stage. Material and methods: from the Evidence Based Nursing methodology, 24 topics of interest were identified and 45 clinical questions were formulated. A literature search in 22 databases with key words in English and Spanish was performed. Results: 150 documents related to the topic were found, critical lecture was applied to 49 direct care studies, and it was managed to answer 24 clinical questions with 58 recommendations. Much of the evidence corresponds to level 2 + according to the Scottish Intercollegiate Guidelines Network classification, and most of the recommendations are Grade C. It is important to point that nine systematic reviews recommendations Grade A and B were found, as well as 3 qualitative studies published by Colombian, Brazilian and American nurses. Conclusions: most of clinical and pathophysiologic reports come from medical research, fewer reports are made by nurses. The current evidence available for nursing is not limited to purely clinical issues; there are new non-pharmacological strategies for pain management, to promote comfort and to prevent delirium in children, and also a theoretical and scientific support for addressing the needs of parents of patients is found, who also face stressful situation and merit receiving nursing care.

Intervenção educativa para o automonitoramento da drenagem contínua no pós-operatório de mastectomia / Educational intervention for self-management of continuous drainage in the postoperative period of mastectomy / Intervención educativa para el automonitoreo del drenaje continuo en el posoperatorio de mastectomía

Trata-se de um estudo de intervenção educativa desenvolvido com o objetivo de avaliar o desempenho de pacientes submetidas à cirurgia por câncer de mama, no automonitoramento do sistema de drenagem contínua. Foi realizado no Ambulatório de Mastologia do Hospital São Paulo da Universidade Federal de São Paulo, entre maio de 2009 e março de 2010, após aprovação pelo Comitê de Ética em Pesquisa dessa instituição. Participaram 79 mulheres que realizaram cirurgia por câncer de mama e portadoras do dreno. A intervenção constou de: aula e simulação do manejo do sistema de drenagem contínua, avaliação do desempenho e reforço das orientações. Constatou-se que o treinamento com foco no autocuidado exercido pelas pacientes, bem como a estratégia utilizada influenciaram favoravelmente o automonitoramento do sistema de drenagem contínua, propiciando a prevenção de obstrução do mesmo, evidenciada pelo percentual de pacientes que mantiveram a perviedade do sistema (84,2%).

This study assessed how well patients who had undergone breast cancer surgery monitored their continuous drainage system after receiving one-to-one instructions at the Mastology Outpatient Clinic of Hospital São Paulo at Federal University of São Paulo. Participants were 79 women who had undergone breast cancer surgery between May 2009 and March 2010, and were using a drain. It was found that the self-care training that the patients received, in addition to the strategy used in that training, had a positive effect on their self-monitoring of the continuous drainage, which prevented the drain from clogging, evinced by the percentage of patients who maintained the permeability of the drainage system (84.2%).

El objetivo de esta investigación fue evaluar el desempeño de pacientes sometidas a cirugía por cáncer de mama, en lo que respecta al automonitoreo del sistema de drenaje continuo, después de haber pasado por acción educativa individualizada, con apoyo de manual instructivo. Se trata de un estudio de intervención educativa, realizado en el Ambulatorio de Mastología del Hospital São Paulo, de la Universidad Federal de São Paulo, de mayo de 2009 a marzo de 2010, previamente aprobado por el Comité de Ética en Investigación de la institución. Participaron 79 mujeres sometidas a cirugía por cáncer de la mama y portadoras de dreno. Se constató que el entrenamiento direccionado al autocuidado realizado por las pacientes, así como la estrategia educativa utilizada, influenciaron positivamente el automonitoreo del sistema de drenaje continuo, propiciando la prevención de la obstrucción, evidenciada por el porcentaje de pacientes que mantuvieron el sistema desobstruido (84,8%).

Estrategia de tratamiento de las fracturas de la cadera, 2010 / Treatment strategy of hip fractures, 2010

Objetivo: mostrar la influencia de los factores preoperatorio y posoperatorio en el resultado final del tratamiento rehabilitador de las fracturas de cadera en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Métodos: se hizo un estudio observacional, descriptivo, longitudinal prospectivo, en el cual se trabajó con 68 casos de ingreso por fractura de cadera en el período enero-junio de 2010, operados o no, y que residieron en el municipio de Cienfuegos. Las principales variables evaluadas desde el momento de la fractura hasta 1 año después fueron: edad, sexo, validismo, comorbilidad, complicaciones preoperatorio y posoperatorio, resultado final. Todos se recopilaron en el período estudiado y se registraron en un formulario de datos creados al efecto; además de las hojas de chequeo anestésico, evaluación geriátrica y expedientes clínicos. Resultados: dentro del conjunto de resultados resalta el grupo de edades de 80 a 89 años que predomina en 50 porciento de los pacientes estudiados, así como el sexo femenino con 72 porciento las fracturas extracapsulares resultaron las más frecuentes en 63 porciento del total. Las complicaciones ortopédicas se presentaron en 23 porciento de los casos, se le realizó rehabilitación preoperatoria a 76 porciento, posoperatoria mediante 1 a 7 d a 96 y 86 porciento a los pacientes valorados en consulta especializada de cadera; 89 porciento de los pacientes lograron deambular libremente con algún tipo de ayuda. Conclusiones: los resultados demuestran la experiencia alcanzada por los especialistas en el empleo de las nuevas tecnologías en la realización del acto quirúrgico. Las valoraciones preoperatorias tanto por geriatría o anestesia y la realización de una rehabilitación precoz, a partir de medidas higiénicas sanitarias, psicológicas con seguimiento ambulatorio estricto, y controlando el cumplimiento del entrenamiento familiar en el cuidado de estos pacientes

Objective: to demonstrate the influence of preoperative and postoperative factors in the final result of rehabilitation treatment of hip fractures in patients admitted in the Gustavo Aldereguía Lima University Hospital of Cienfuegos municipality. Methods: a prospective, longitudinal, descriptive and observational study was conducted in 68 cases admitted due to hip fracture from January to June, 2010, operated on or not residents of this municipality. The main variables assessed from the moment of fracture up to one year after were: age, sex, validity, comorbid disease, preoperative and postoperative complications, final result. All were collected in the study period and were registered in a data form created to that end, in addition to the anesthetic checkup sheets, the geriatric assessment and the clinical records. Results: in the group of results is highlighted the age group of 80 to 89 years with predominance in the 50 percent of study patients, as well as the female sex with the 72 percent the extracapsular fractures were the more frequent in the 63 percent of total. The orthopedic complications were present in the 23 percent of cases, preoperative rehabilitation in the 76 percent , postoperative over 1 to 7 days in the 96 and the 86 percent of patients assessed in hip specialized consultation, the 89 percent of patients achieved to walk freely with some type of help. Conclusions: results demonstrate the experience obtained by specialists in the use of new technologies during the surgical act. The preoperative assessments by Geriatric or Anesthesia and the performing of an early rehabilitation, from the health and psychological measures with an strict outpatient follow-up and controlling the fulfillment of family training in the care of these patients

Comportamiento intrahospitalario entre las fracturas de cadera intracapsulares y las extracapsulares / Intrahospital behavior between the intracapsular and the extracapsular hip fracture

Objetivo: establecer la diferencia que existe en el comportamiento intrahospitalario entre la fractura de cadera intracapsular y la extracapsular. Métodos: se realizó un estudio retrosprospectivo de tipo transversal con todos los pacientes operados de fractura de cadera (400 pacientes) que ingresaron en el servicio de ortopedia y traumatologÝa del Hospital Provincial José R. López Tabrane desde enero de 2008 hasta diciembre de 2009. Resultados: se encontraron 277 pacientes (69 porciento ) con fracturas extracapsulares, con un predominio del sexo femenino para ambas fracturas. En los 2 grupos predominó el color de la piel blanca y el grupo de edades de 80 a 89 años. La cadera izquierda resultó la más afectada en las fracturas extracapsulares y en las intracapsulares predominó la cadera derecha. En ambas fracturas el tiempo operatorio fue entre 1 y 2 h (95 porcientio), promedio 1,27 min; las complicaciones resultaron similares, pero predominaron las complicaciones médicas en las intracapsulares (76 porciento), y las quirúrgicas en las extracapsulares (40 porciento). La neumopatía aguda inflamatoria fue la complicación médica más frecuente en ambos grupos. Dentro de las quirúrgicas la celulitis resultó la más representada. Tanto la estadía preoperatoria, posoperatoria como el total resultaron similares en ambos grupos. En el tratamiento la lámina 130 y el tornillo (36 porciento) predominaron en las extracapsulares, y la prótesis parcial en las intracapsulares (39 porciento). En cuanto al estado al egreso fue el mismo en ambos grupos, 97 porciento vivos y 3 porciento fallecidos. Conclusiones: las fracturas extracapsulares se presentaron con más frecuencia que la intracapsulares con un ligero predominio de las complicaciones en este grupo a expensas de las médicas

Objective: to establish the difference in the intrahospital behavior between the intracapsular and the extracapsular hip fracture one. Methods: a cross-sectional and retrospective study was conducted in all patients operated on due to hip fracture (400 patients) admitted in the Orthopedics and Traumatology service of the "JosÚ Ram¾n L¾pez Tabrane" Hospital from January, 2008 to December, 2009. Results: two hundred and seventy seven patients (69 %) presenting with extracapsular fractures, with predominance of white race and the age group of 80 to 89 years were found. The left hip was the more involved one in the extracapsular fractures and in the intracapsular ones the was predominance of the right hip. In both types of fractures the operating time was between 1 and 2 h (95 %), mean 1.27 min, the complications were similar but with predominance of medical complications in the intracapsular ones (76 %) and the surgical ones in the extracapsular type (40 %). The acute inflammatory pneumonia was the more frequent medical complication in both groups. Into the surgical ones, the cellulitis was the more represented. The preoperative, the postoperative as a total were similar in both groups. In the treatment the #130 layer and the screw (36 %) predominated in the extracapsular ones and the partial prosthesis in the intracapsular ones (39 %). As regards the discharge status was the same in both groups, 97 % of lives and the 3 % of deceased. Conclusions: the extracapsular fractures were present were more frequent than the intracapsular ones with a slight predominance of complications in this group at the expense of the medical ones

Morbilidad y mortalidad por fractura de cadera / Morbility and mortality due to hip fracture

Objetivo: demostrar las causas fundamentales que atentan contra la morbilidad y mortalidad de los pacientes operados de fractura de cadera. Métodos: se realizó un trabajo descriptivo, transversal y prospectivo de los pacientes operados de fractura de cadera en el Hospital General Dr. Ernesto Guevara de la Serna, en el período comprendido entre enero de 2007 y septiembre de 2009. Resultados: se demostró un predominio de esta lesión en el sexo femenino (60,7 por ciento) y en los pacientes entre los 71 y 80 años de edad (26,6 por ciento), igualmente la cirugía de urgencia fue la opción terapéutica más usada en 69,3 por ciento de los casos; las fracturas trocantéricas resultaron las más frecuentes. La descompensación de enfermedades de base y la decisión familiar, con 25,3 por ciento, 18,7 por ciento y 16 por ciento fueron las principales causas que obstaculizaron la cirugía de urgencia. En los pacientes con una estadía preoperatoria menor de 72 h, el porcentaje de complicaciones fue bajo. Conclusiones: la desorientación, la bronconeumonía y las escaras de decúbito, resultaron las complicaciones más frecuentes. El porcentaje de fallecidos fue mucho mayor en los pacientes con familias disfuncionales que en las familias funcionales, demostrándose el papel determinante del entorno familiar en la evolución y el pronóstico de estos pacientes

Objective: to demonstrate the main causes to attempt the morbility and mortality of patients operated on hip fracture. Methods: a prospective, cross-sectional and descriptive study was conducted in the patients operated on hip fracture in the Dr. Ernesto Guevara de la Serna General Teaching Hospital from January, 2007 to September, 2009. Results: there was predominance of this type of lesion in female sex (60.7 percent) and in patients aged between 71 and 80 (26.6 percent); the emergency surgery was the therapeutical option more used in the 69.3 percent of cases; the trochanteric fractures were the more frequent ones. The decompensation of base disease and the family decision with a 25.3 percent, 18.7 percent and 16 percent were the leading causes hampered the emergency surgery. In patients with a preoperative stage less than 72 h, the percentage of complications was low. Conclusions: the disorientation, bronchopneumonia and decubitus sores were the more frequent complications. The percentage of deceased was greater in patients with dysfunctional families than in the functional ones, demonstrating the determinant role of family environment in the natural history and prognosis of these patients

Cuidados de enfermería al paciente con herida de safenectomía / Nursing care for patients with saphenectomy wound", "_i": "

Uno de los objetivos del profesional de enfermería durante el proceso de atención a pacientes es el de contribuir a la recuperación de la salud del enfermo, por lo que resulta indispensable que los procesos que se encuentran a su cargo se realicen de forma unificada y estandarizada para proporcionar cuidados seguros y de calidad, que eviten complicaciones derivadas de éstos. Ante esta perspectiva se propone el siguiente proceso de cuidados de enfermería al paciente con herida de safenectomía por cirugía de revascularización coronaria con hemoductos venosos de safena.

One of the objectives of the professional of nursing during the process of attention to patients is the one to contribute to the recovery of the health of the patient, reason why it is indispensable who the processes that are their position are realised of form unified and standardized to provide safe cares and of quality, that they avoid complications derived from these. Before this perspective the following process of well-taken care of from nursing sets out to the hurt patient with of safenectomia by surgery of coronary revascularization with venous hemoductos of safena.

Assessment of postoperative follow-up for patients with recurrent kidney stone

Kidney stones are one of the most common and most painful medical problems known. Nurses assess and monitor patients through diagnosis and treatment and teach patients how to avoid recurrence of stones]. A descriptive study was conducted on 150 patients diagnosed with recurrent kidney stones, who were attending the out patients consultation urology disease clinics at surgical specialties, Al-Kadhimia, Al-Yarmook, and Al-Karama Teaching Hospital and Extracorporeal shock wave lithotripsy [ESWL] departments for the period from the 1st of Feb. 2002 through to the end of May 2004. The aim of the study is to assess the post-operative follow-up for patients with recurrent kidney stones. None- probability [purposive sample] of 150 patients with recurrent kidney stones The reliability and validity of the instrument were determined through a pilot study. The data were collected through the use of constructed questionnaire and analysis through the application of descriptive statistical analysis procedures which included. [Frequency, percentage, mean score, stander deviation, relative sufficiency] and application of inferential statistical analysis which included the [Chi-square] The finding of the study indicated that follow-up of the majority of the study sample was poorly and unsatisfactorily concerning doing regular periodic laboratory and diagnostic tests, fluid intake, and medication intake. Based on the results of the study the researcher recommend to establishment of discussion room for the nurse in charge in out patient urology disease consultation department to meet those patients who were attending this clinic for follow-up to discuss with them issues concerning follow-up in relation to doing regular periodic laboratory and diagnostic tests, diet, fluid intake, and medication and, providing them with a written bulletin concerning complete information about follow-up of patients post operatively after removal of kidney stone

Assessment of health education which is provided to postoperative patients with gallstone "obstructive jaundice"

A description study was carried through out the present study aimed to assess health education provided by nurses to patient with gall stone "obstructive jaundice". The study was conducted at 4 teaching hospital, Baghdad teaching hospital, Al-Karama teaching hospital, Al-Yarmook teaching hospital, Al-Kendy teaching hospital where choloecystectomy was performed, in the period from first of June 2004 to end of July 2004. Data were collected through the use of questionnaire an interview from which was developed for the purpose of the present study. A non-probability [purposive] sample which was consisted of [50] nurse who were dealing with patients who had choloecystectomy. The main result of the study revealed significant association between nurse's gender, education level and their providing of health education about gall stone "obstructive jaundice" to the patients